The changing pattern in peptic ulcer surgery.

T Suchý, K Kabelác, B Jon, I Pospísil
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Abstract

The authors analyse the methods of treatment for the peptic ulcer disease (PUD) in two 5-year periods (group A 1979-1983, group B 1985-1989). From these groups patients with perforated gastroduodenal ulcer were excluded. In the first period 206 operations were carried out using nearly exclusively classical partial gastrectomies of both types (94 per cent). The second period involves 94 operations, where the most frequent type of operations was the proximal gastric vagotomy (40.4 per cent), and vagotomy with anthrectomy in the Roux-en-Y modification (26.6 per cent). The number of operations for a complicated PUD has increased from 43.2 per cent to 53.2 per cent, the ratio between the duodenal and gastric ulcer has changed from 3:1 to 2:1. The mortality was 5.3 and 4.7 per cent respectively, the morbidity 14.5 and 13.8 per cent respectively. The authors confirmed their accordance with the world-wide trend of diminution of the proportion of surgically treated PUD and a shift in the pattern of surgical methods towards the non-resective and more physiological procedures.

消化性溃疡手术的变化模式。
作者分析了消化性溃疡病(PUD)的治疗方法,分为两个5年(A组1979-1983年,B组1985-1989年)。排除胃十二指肠溃疡穿孔患者。在第一阶段,206例手术几乎完全采用两种类型的经典部分胃切除术(94%)。第二阶段涉及94例手术,其中最常见的手术类型是胃近端迷走神经切开术(40.4%)和Roux-en-Y改良术中迷走神经切开术加anthectomy(26.6%)。复杂PUD的手术数量从43.2%增加到53.2%,十二指肠溃疡和胃溃疡的比例从3:1变为2:1。死亡率分别为5.3%和4.7%,发病率分别为14.5%和13.8%。作者证实了他们符合世界范围内手术治疗PUD比例减少的趋势,以及手术方法模式向非切除性和更生理的手术转变。
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